July 26, 2012

USC Dornsife’s Problem Without Passport BISC 428 (The Biology of Tropical Medicine) course enters its second year this summer at Oxford University amidst the excitement for London’s 2012 Olympic gala! We have 20 clever student participants each with an interest in a medical career.

As I packed my suitcase to travel back to Oxford, I was grateful for the sense of experience that I knew I would accompany me this time. Though the course was a success for it’s initial run, we were faced with a number of challenges. As I write, the course is smoothly entering its second week. Experience is indeed a good teacher!

One tremendous enhancement to the program this summer is the inclusion of Dr. Erin Quinn as the program faculty member. She is the Associate Dean at the Keck School of Medicine and her familiarity with medical practices and conditions has enabled us to engage in thoughtful discussions each afternoon reflecting on the topics covered in that morning’s lectures.

As last summer, the course revolves around daily lectures given by multiple physicians and professors associated with Oxford University. All are experts in their chosen filed of tropical medicine. Each has spent considerable time in various African or Asian countries where malnutrition and maladies such as malaria, cholera, HIV or tuberculosis are rampant. They invited us to mentally examine medical practices and problems outside of our “western-medicine” comfort zone. The reflections using these perspectives, are giving the students a greater sense of the vast scope of these dilemmas.

In the afternoons, our classroom expands to the city of Oxford and the 38 colleges that comprise the University. We have toured the Bodleian Library which houses books from as early as the 11th century. We have seen the home and now library of Dr. William Osler who was one of the four founding professor of Johns Hopkins Hospital. We have perused the collections on display in the Ashmolean, Natural History and Pitts River Museums. We have visited the favorite haunts of J.R.R. Tolkien, C.S. Lewis, Bill Clinton and USC’s own Pat Haden. The weekends allow us to further expand our studies geographically. This past weekend in Stratford-upon-Avon gave us a look at Shakespeare’s time period and we took in modern rendition of The Twelfth Night at the Royal Shakespeare Theater. This coming weekend looks to hold an Olympic experience for the students.

USC students in front of the Royal Shakespeare Theater prior to seeing Macbeth performed. Photo by Judy Haw.

We have learned that not all of our stereotypes of British culture are accurate as the food has been smashing and the weather brilliant!

The following blogs written by the students are meant to share our experiences while giving the students an opportunity to reflect on a topic presented in our lectures.

Cheers!

Judy Haw is director of the USC Dornsife Supplemental Instruction program. She is also the associate director of the Freshman Science Honors Program.

August 2, 2011

We set off at eight in the morning—which, to a college student, is basically the crack of dawn—and in the minibus, most of us promptly fell asleep. But I eventually did wake up, and as we rode from Oxford to London to the tune of an oldies radio station, I felt my excitement building despite sleep deprivation. The day was planned to be packed full of special museums and exhibits, and I could hardly wait for our whirlwind overview of the history of medicine.

Our first stop was the Wellcome Collection, a fascinating place that calls itself “a free destination for the incurably curious.” I am not sure exactly what I was expecting, but I was simultaneously startled and delighted to see that their exhibits boldly explore the intersection of science and art. Some examples are a map made of mosquitoes to illustrate the worldwide scourge of malaria; a karyogram composed of the artist’s socks; and an elegant glass container of genetically modified soybeans that could represent a trophy… or a time bomb. One of my favorites was a tall shelf of enormous books that contained the entire human genome printed in nearly illegible letters. I definitely appreciated the Wellcome Collection’s willingness to blur the line between art and medicine, because in my opinion, few things are more artistic than the intricacies and paradoxes of the human body.

Next we walked to the British Museum and headed to the third floor, where museum curator Ralph Jackson showed us around and spoke to us about medicine in ancient Rome. I have always loved learning about the ancient Romans, so this was a highlight for me. Despite all that they did not know about the human anatomy, let alone microscopic agents of disease, they were amazingly sophisticated physicians.For example, we learned that they were able to successfully remove cataracts, as well as to drill holes in patient’s skulls in the medical procedure known as trepanation. Plus, Ralph Jackson provided us with a vivid example of the way textual and archeological evidence is pieced together to understand history. I only wish we had been able to spend more time at the British Museum, but considering its enormous scope, it would probably have taken me at least the entire day to be satisfied!

We stopped briefly at the John Snow Pub, which is named after the physician who identified contaminated water as the cause of cholera after a massive outbreak in the area nearby. After lunch, we explored the Hunterian Museum at the Royal College of Surgeons. I was fascinated despite myself by the rows upon rows of organs in jars and bones behind glass. As I wandered the maze of displays, I found myself wishing that I was already in medical school so that I could know exactly what I looking at, without having to read the caption below each specimen. Just before leaving, a group of us watched a video of brain surgery. It was so much fun to see the excitement in everyone’s faces, and to think that one day, we will be the ones performing surgery and caring for patients.

Throughout the day, in multiple exhibits, we saw a myriad of surgical tools ranging from lancets to Liston knives. Many of the devices we saw were extremely impressive and painstakingly fashioned, but they still bore little resemblance to the pristine, antiseptic image of surgical instrumentation to which I am accustomed. Certain displays resembled rows of torture devices: menacing knives, needles, and saws of all shapes and sizes. Though some objects were strikingly familiar, like the collection of obstetrical forceps from throughout the years, I was at times overwhelmed by how different it all seemed from modern medicine. Limited knowledge of the human anatomy? I can hardly imagine attempting to heal the body without really understanding its inner workings. Inadequate anesthesia? Taking a knife to someone’s flesh is much more daunting when you know they might be able to feel it. And though the ancient Romans successfully managed it, trepanation in the days before modern medicine seems a gruesome prospect. Looking at the anatomical preservations of bodies robbed from graves, I wondered if I would have been able to stomach the practice of medicine a few hundred years ago. But then I remembered the first thing we were shown at the British Museum—and for me, the most poignant thing.

It was a marble tombstone from the second century AD, with the sculpted image of a doctor examining a patient. In the image, the patient is looking straight into the doctor’s eyes, and though this is a small detail I found it striking. There are some things that never change, and one of those things is the human element of medicine. Who knows? One day we may discover a way to fix injuries with the flick of a switch and solve disease with the touch of a button (stranger things have happened). But no matter how technologically advanced we become, I do not think we can ever get rid of the vital connection between doctor and patient—the trust that the patient puts in the doctor, and the responsibility of the doctor towards the patient, as someone who is able to help.

Left: Container of genetically modified soybeans. Is it a trophy or a bomb? From the Wellcome Collection, London. Right: Marble tombstone of a physician from 2nd century AD. From the British Museum, London. Photo by Otana Jakpor.

In the broader arena of global health, although the players are different, the principle remains the same. After all, the most basic principle is that we are all human. There are, of course, self-interested reasons to care about global health—since the spread of disease is facilitated by the ease of rapid transportation, protecting health in distant lands equates with protecting yourself. But at the root of it all, global health is not just about economics or politics or international relations, though these things are inextricably connected and vitally important. Global health matters because as human beings, we all have the right to health, which, to quote the WHO, is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” And until that end is reached, the human element of medicine compels us to keep fighting on for global health.

Otana Jakpor is a sophomore majoring in global health from Riverside, Calif.

July 28, 2011

USC students at Shakespeare’s birthplace in Stratford-upon-Avon. Photo by Judy Haw.

After a week of multiple captivating lectures by inspired professors and physicians with different backgrounds and interests, we as a group were fortunate to travel to Stratford-upon-Avon, the birthplace and hometown of a man whose work is famous and distinguished among all cultures of the world—William Shakespeare. Studying at Oxford University, one of the oldest teaching institutions in the world, I wondered why the incredibly creative Shakespeare wasn’t an alumnus. Saturday morning at Shakespeare’s actual home, now an exhibition, my question was answered; John Shakespeare his father was a glover, a job of the lower class so William didn’t have the money to attend Oxford or Cambridge. After being educated in a grammar school until the age of 14 and getting married four years later, young Shakespeare began his quest to greatness.

Seeing the bed Shakespeare slept on, walking through the hall where he ate his meals, and sitting on the very steps by the garden where he may have sat and thought of his brilliant ideas and stories, I analyzed every detail of the walk. This was an experience that I would share with my kids one day. Next up was the house of his older wife, Anne Hathaway. She was 26 years old when she married the younger 18-year old Shakespeare, who apparently had to work hard for her hand in marriage. According to the guide, Anne Hathaway made frequent visits to the town of Stratford and Shakespeare spent a lot of time courting Hathaway for her love. After marriage, Shakespeare went on to London where he joined a theatre company and composed works that became favorites of Queen Elizabeth. He earned enough to retire and live in the second-largest house of his hometown, Stratford.

USC students in front of the Royal Shakespeare Theater prior to seeing Macbeth performed. Photo by Judy Haw.

Now as the day was coming to a close, one of my classmates mentioned to the group the conspiracy surrounding whether Shakespeare was a fake. We all looked at each other, shook our heads, and knew—after a day filled with accurate facts and concrete evidence of his works, home, and existence—that the conspiracy wasn’t true. The conspiracy questions how a man who received education from a rural town grammar school up to the age of 14 became the greatest playwright of all time and undoubtedly influenced the linguistic patterns and phrases of the English language. After visiting Stratford, my fellow classmates and I were convinced. Using a quote from Shakespeare’s play Twelfth Night, “some are born great, some achieve greatness, and some have greatness thrust upon ‘em.” William Shakespeare was a man of all three.

Gabe Bouz is a sophomore double majoring in biology and psychology in USC Dornsife.